Rowman & Littlefield Publishers Blog

Make Them Answer the Tough Questions: The Realities of Political Debate and Health Care in 2008

By Carey Kriz

The elephant is in the room, and it is time that the political parties seeking to run the U.S. government start acting like they understand the issues of U.S. health care in 2008. First a couple of questions that we need to start asking: Will universal health insurance fix our health care system? The answer is easy: absolutely not. A bumper sticker approach to solving problems means identifying one big emotional issue and suggesting an obvious solution. For health care there a number of these, with the big story being the unfeeling administrator denying benefits to a patient with real needs. Ultimately, this story comes back to the failure of our insurance industry to be portable, to be with you throughout your lifetime and generally to be fair.

And yes, this is a great cause. But it is not the answer.

Will more doctors bring more health care to our communities? The answer to this one is also easy: absolutely not. The U.S. system of educating and branding physicians is arguably the best in the world. Yet we have an imbalance in knowledge and need to think about why our neighbors are getting so fat, or indulging in behaviors that are obviously bad for them. Do any of us understand that we are actually in charge of our bodies?

Will blockbuster science and new drugs cure disease? Dreaming is good for us, and we do have a number of major scientific advances that impact the world of health care – and how that health care can lead to improved longevity and a better quality of life. But science alone is not the answer here. We have a problem in health care that cuts across treatments, diagnosis and infrastructures.

So what will fix our health care system? For the answer to this question start asking your political leaders where all the money is going – and whether we have any idea of the cost/benefits of our investments. When we think of spending money on health care what we fail to also mention is that we spend more than anyone else in the world, that we have declining productivity in our quality of life indices, and are making a “business” out of something that comes close to being a survival requirement. Guess who pays the highest cost for drugs in the world? Yes: we do. Not your neighbors in Australia and Singapore – or Europe.

Imagine how stupid we would look as a society if we charged for the right to breathe air. Now imagine denying someone access to care because they slipped through the coverage cracks – or discriminating against them because they already had a disease. Now add to this reality that a ton of people were making money from this mess, including big investment funds, management, professionals and shareholders. Yes we have cancer and it has metastasized into every corner of the health system. The fix will not be pleasant and will definitely be painful. But it is a requirement and it will be hard on all of us.

So it’s time to put some real debate into health care and start looking at the elephant of big business, profits and motivation. Hiding from a problem, or misleading the public about how bad it is, will not solve it.

Carey Kriz is the author of The Patient Will See You Now (Rowman and Littlefield).

Science and Religion: Toward Common Ground

By Edward F. Kelly   

        Conflicts between science and religion have erupted intermittently since the first stirrings of modern science over four centuries ago, and the past year has witnessed searing new attacks on religion by Daniel Dennett, Richard Dawkins, and other defenders of Enlightenment rationalism. Critics like these clearly regard themselves, like science itself, as marshalling the intellectual virtues of reason and objectivity against retreating forces of irrational authority and superstition. In their view science has conclusively demonstrated that we human beings are nothing but complicated biological machines. Everything we are and do is in principle explainable in terms of our biology, chemistry, and physics. Mind and consciousness are generated by—or in some mysterious way identical with—neurophysiological processes occurring in brains. Mental causation, volition, and the “self” are illusions, by-products of the grinding of our neural machinery. And because we are entirely the product of this machinery, we are necessarily extinguished, totally and finally, by the death and dissolution of our bodies. To think anything different is to abandon centuries of cumulative scientific progress and revert to the primitive supernaturalist beliefs of bygone times. Period, end of story.

          In reality things are less clear-cut and much more interesting. My intent here is not to side with the institutionalized religions against science. All seem imperfect human creations, and I do not adhere personally to any. But I do believe that real understanding of human nature will be achieved only by expanding current scientific orthodoxy in directions broadly compatible with the central impulse of religion as characterized by the great American psychologist and philosopher William James in his classic Varieties of Religious Experience, and I further believe that the primary obstacles to doing so reside within science itself.

      The word “fundamentalism” probably evokes for most of us only images of bomb-wielding Islamic terrorists and other examples of religious extremism, but fundamentalism exists within science as well. When scientific opinion hardens into dogma it becomes scientism, which is essentially a secular faith and no longer science. Galileo was persecuted by the Inquisition, but in modern times the main opposition to new scientific ideas has derived not from religious orthodoxies but from other scientists for whom contemporary opinion established the limits of the possible.

      Consider in this light the question of post-mortem survival. The notion that aspects of mind and personality survive bodily death is central to the world’s great religions yet scorned as impossible by present-day establishment science. But few participants in this contentious debate have any inkling that there exists a large scientific literature collectively suggesting that at least some of us, under largely unknown conditions and for some unknown period of time, do in fact survive. The primary threat to this interpretation, ironically, has nothing to do with the quality of the evidence—problems of fraud, credulity, errors of observation or memory, and the like—but with the difficulty of excluding non-survivalist interpretations based solely upon supernormal (“psi”-based or parapsychological) processes involving living persons. The voluminous evidence for such processes includes both spontaneous cases and experimental studies, and in my opinion has long since passed the threshold where competent persons who take the trouble to study it in depth and with an open mind will routinely conclude that these things exist as facts of nature. Indeed, future generations of historians, philosophers, and sociologists will undoubtedly make a good living trying to understand why it took so long for scientists in general to accept this conclusion.

      Either horn of this interpretive dilemma — survival or psi — is lethal to current materialist orthodoxy, which undoubtedly helps explain the hostility of its advocates to both. But many other psychological phenomena pose similarly difficult challenges to conventional ways of thinking. Conditions such as cardiac arrest and general anesthesia, for example, abolish brain conditions regarded by most neurophysiologists as necessary for full consciousness, yet thousands of patients have reported extraordinarily vivid, life-transforming experiences that occurred under these circumstances. Even the most fundamental aspects of everyday mental life including memory, volition, and the qualitative “feels” of consciousness remain unexplained. Everything points, I believe, to the need for an enlarged scientific psychology that can accommodate “transpersonal” or spiritual aspects of human nature without loss of rigor.

      There are more things under Heaven and Earth than are dreamt of in today’s mainstream materialist philosophy, and huge questions that so far have been addressed primarily by the world’s great religions are to some degree accessible to the methods of science. There is middle ground between science and the religions as presently constituted, and noisy partisans on both sides ought to know this! As William James himself declared in A Pluralistic Universe, his last book, “Let empiricism once become associated with religion, as hitherto, through some strange misunderstanding, it has been associated with irreligion, and I believe that a new era of religion as well as philosophy will be ready to begin.”

Edward F. Kelly is a Research Professor in the Department of Psychiatry and Neurobehavioral Sciences at the University of Virginia in Charlottesville. He is also the lead author of Irreducible Mind: Toward a Psychology for the 21st Century.

Chinese Military Hackers Attack Foreign Government Computers?

By  Xu Wu

First Germany, then United States, then France, then Australia. One after another, countries join the chorus accusing that China’s People’s Liberation Army (PLA) was behind the recent malicious attempts to hack into foreign governments’ computer systems. Although by no means bullet-proof, most of the reports, or at least their normally anonymous sources, hinted two “facts”: first, these hacking activities were carried out by Chinese military or its affiliated agencies; second, the Chinese government, or more specifically, some top-level officials, knew about and support these operations. Although not a computer expert, I found both the premises, and the logic, not to mention the conclusion, are problematic.

Suppose, (1) that these hacking activities did occur as accused—let’s ignore the suspicious two- to three-month time lag between the crime and the disclosure; (2) that this kind of online activities is universally rejected, forbidden, loathed, and demeaned, and no civilized country on the earth will engage in this type of low-class, immoral information-gathering intrusions; (3) that these attempts did originate physically from China—(let us just pretend the above conditions are all met, for the sake of discussions)—I still could not figure out how they pinpointed China’s military as the guilty party and blamed the Chinese government for the wrongdoing.    

Here are my reasons, from the technologically amateurish to the politically incorrect. 

First, every morning while sitting before my office computer and checking my online inbox, I have to delete those admirably persistent spam e-mails, normally with a weird name and address. The online administrator at my institution has promised and updated many times the filtering software, but, on average, I still receive more trash e-mails than the useful ones. If the spam spreaders can somehow find a way to evade the cat-and-mouse cyber chase and hide their identities, I don’t know why the “quasi-formidable” Chinese military cyber geeks can not hide. If they are technologically savvy enough to break into some of the most sophisticated computer systems in the world, shouldn’t they know how to use proxy software and other hacking tools to erase the trace? 

Second, even if the perpetrators are indeed Chinese citizens living inside China (Guangzhou and Lanzhou, to be more specific), how can the accusers identify with certainty that those perpetrators were PLA agents, operating with the support of the government? Why couldn’t they be a small group of technologically savvy “cyber nationalists” who initiated these rampant and bald moves? Let us not forget, there are over 140 million online users in China, half of them using broadband fast-speed Internet surfing online. If you still think this scenario is unlikely, take a look at several “historical” events occurred not so long ago. In May 1999, when the news broke that Chinese Embassy in Belgrade was bombed by a U.S. B-2 stealth bomber, a group of self-organized Chinese hackers defaced the website of the U.S. Embassy in China within 12 hours, and knocked out of service the White House’s official website, the first time in its history. Two years later, when diplomats from China and United States were busy tangling on the most appropriate way to say “sorry” over the spy-plane collision incident, an estimated number of 80,000 Chinese hackers participated in the so-called “Red May Self-Defense Cyber Warfare,” fighting with an unknown number of American hackers. Several thousands of business, educational, governmental, even military websites on both sides fell prey to this unprecedented massive cyber-nationalistic anger. In a summary report, New York Times reporter even named this online conflict the “World Wide Web War I.”

It has become a thinking pattern among many Western observers that anything happened in China was the result of Chinese government’s or PLA’s calculated maneuver. Even this assumption seems reasonable twenty years ago, it is fairly outdated nowadays, given the breathtaking development and diversification in China’s economic, societal, cultural, and even political decision-making sectors. A couple of months ago, two Chinese young scholars in different occasions voiced their personal opinions on China’s huge foreign reserve. Because their position was different from the official line, a rain of protests, accusations, warnings, demands were filed in front of Chinese government’s doorsteps. If an American economist can have his or her different view on financial policy, why can’t a Chinese scholar? If opposing China’s political policy belongs to the “freedom of speech,” why opposing China’s monetary policy becomes a “foolhardy” troublemaker?

An interesting analogy can also be made between these online hacking incidents and the ongoing safety issues involving the “made-in-China” products. Yes, those defective products were made in China, but they were not made by the “Chinese government.” Although the government shares the burden of enforcing high-quality regulations, it is those tens of thousands of manufacturers or even those American importers who should be blamed for the lack of quality control and inspection. Also, although the label says “made-in-China,” it is, to a large extent, only assembled in China. In other words, just like those evasive online hackers, unless you catch them blood in hands, who knows where they are from, who they are, and what they are doing for?

Xu Wu is assistant professor of strategic media and public relations at Arizona State University and author of Chinese Cyber Nationalism: Evolution, Characteristics, and Implications.

Health Care and SiCKO

Say what you will about Michael Moore and his controversial movies, but his newest, “SiCKO” is going to get a lot of people talking. Health care reform is shaping up to be a major issue in the coming presidential elections, with Senators Obama and Edwards preaching universal health care and Sen. Clinton reworking her past health care reform attempts. What “SiCKO” will do is help expand the idea of serious health care reform past DC political junkies and into the mainstream.

Do we really have the worst health care system in the western world, as Michael Moore would have us believe? Is major change in our current system even possible? If you’re interested in learning more about the issues raised in “SiCKO”, Health Care Half-Truths: Too Many Myths, Not Enough Reality is a great comprehensive overview. Written by the provost of the University of Virginia’s School of Medicine and a Health Policy Analyst at UVA, reading this thoroughly researched book will ensure that your opinions on health care reform are informed by more than just one source.

One aspect of corruption in our medical care that was left out of “SiCKO” is the coalition of pharmaceutical companies and doctors at the expense of medical ethics. Hooked: How Medicine’s Dependence on the Pharmaceutical Industry Undermines Professional Ethics addresses just that. Doctors get all kinds of perks from the pharmaceutical industry, from pens to baseball tickets to attention and ego-stroking. All of this gets in the way of doctors making decisions that are good for the patient, including the case of the woman who was on nine medications from the American doctor and was able to cut back to five after getting care overseas.

This is an open forum, and we welcome discussion on this and any other issues posted in this blog. Have you read the books and disagree with their points? Do you know more about the benefits/drawbacks of our current health care system? Comment below!